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DIABETES (27/10) (Management of Blood
Glu levels in T1 (Food intake -β¦
DIABETES (27/10)
-
Complications
- Diabetes affects all bod cells
β Complications in all organs
- Microvascular complications:
~ Neuropathy (nerve damage)
~ Nephropathy (kidney disease)
~ Vision disorders (retinopathy,
glaucoma, cataract, corneal disease)
- Macrovascular: heart disease,
stroke, peripheral vascular disease
(can lead to ulcers, gangrene, amputation)
- Other: infections, metabolic difficulties,
impotence, autonomic neuropathy,
pregnancy problems
- Dentistry:
~ oral infections
~ T2 most commonly
diagnosed by dentists
- Podiatry: circulation
~ peripheral neuropathy
~ charcotes foot
~ diabetic foot ulcers
~ impaired wound healing
-
Diabetes Mellitus
2 Forms:
- Type 1: insufficient Ins production
~ due to autoimmune destruction of π-cells
~ usually develops early in life
~ used to be called "Ins-dpdt" or "juvenile diabets"
~ autoimmune mediated
- Type 2: Ins resistance + progressive π-cell failure
~ Usually develops in late adulthood,
~ & ass w obesity
~ Cells x respond aptly to Ins
~ still ; lots Ins but x work - need Ins therapy
Symptoms
- Both forms: elevated blood sugar
~ (bod in starve mode - none intra cell)
~ bod tries to dilute the blood Glu β excess pee, thirst
- Type 1:
~ Increase Fat bd β lots KBs
~ some ketones are ketoacids - β blood [H+]
~ thus ketoacidosis
- (activate Bicarbonate buffering sys - altered breathing)
- (Bd Acetoacetate (KB) ; Acetone - expelled via breath)
- (Untreated diabetes β dramatic weight loss) [T1]
Common:
- β Thirsty (Polydypsia), Urine (Polyuria)
~ Tired & lethargic, Hungry (Polyphagia)
- Cuts heal slow, Itch & Skins infections, Blurred vision
- Mood swings, Headaches, Dizzy, Leg cramps
- T1: unexplained weight loss
- T2: gradually put on weight
:pencil2: Affect nerves, circulatory & immune sys
- longer have Diabetes, >prone to symptoms
bc uncontrolled Glu levels
What causes Dia?
- Our DNA remained ~unchanged since
~ Paleolithic man:
~ Diet = nuts, berries, low fat
grass fed herbivores, birds, fish
- Hs genetically programmed to:
~ Digest & absorb complicated molcs,
x highly refined foods (eg high fructose corn syrup)
~ Active lifestyle - hunt, fasting
- Now: lotsa calories, highly refined easily
digested foods, no fasting, inactive
Impaired
Glu Levels
- Fasting Glu: 7+ mM = Dia
~ verify w a repeat test
~ preferably a Glu Tolerance test
- Glu Tolerance test: 11.1+ mM = Dia
- Impaired Glu Tolerance test: 7.8-11.1 mM &
- Impaired Fasting Glu: 6.1-7 mM
~ both: x diagnotic Dia BUT indicate risk
- Random Glu test: 3.5-7.5 mM
~ 11.1+ mM x diagnotic BUT req Fasting Glu test
(lotsa tests bc ths influence blood sug levels)
-
T2 Prevention - Summary of Clinical Trials
- Goals:
~ lose weight - 5-10 kg
~ increase walking activity (30 min/day)
or gym (3 days/week)
- Results:
~ 1 case of Dia prevented for every 7-8 ppl who: intensive lifestyle intervention program for 3 yrs
~ Achieve all diet, exercise goals
:pencil2: - standard lifestyle intervention
- medication: stop Hepatic Glu output
LO:
- Describe mechanisms how Type 1 & 2 result
~ eg Type 1 = autoimmune disease
~ (naturally via antibodies, lymphocytes
- Describe symptoms & complications
- Summarise impact of exercise & diet
- Und concepts of Hyper & Hypoglycaemia,
~ impact of impaired Glu levels
Summary:
- T1: req careful balance btn food intake,
Ins therapy, exercise
- Obesity & Metabolic Syndrome β T2
- Too much fat = bad
- Exercise & weight loss can reverse T2 symptoms
- Exercise more!